Adolescent Health Risk Behaviors Research Articles

Is the Brief Multidimensional Student’s Life Satisfaction Scale Valid and Reliable for African American Adolescents?

ABSTRACTBackground: Health promotion/education strive to promote healthful conditions that improve quality of life based on the perceptions of those whose lives are affected Though health promotion/education might have instrumental value in reducing risks for premature morbidity and mortality, their ultimate value lies in contributions to quality of life. Life satisfaction (LS) has been defined as an individual’s assessment of their quality of life based upon personal criteria and linked to adolescent health risk behaviors and developmental assets. Purpose: We investigated the psychometrics of the Brief Multidimensional Students’ Life Satisfaction Scale [BMSLSS] with an adolescent sample of African Americans (N = 1,658) from four mid-sized cities in the United States. Reliability and validity of the BMSLSS has not been determined for samples of exclusively African American adolescents. Methods: Data analysis included calculating mean ratings, standard deviations and effect sizes (Cohen’s d) and inspecting the scale’s internal structure, reliability, and relationships to other variables. Results: Evidence of internal structure, internal consistency reliability, and hypothesized relationships to other variables for participants were determined. Translation to Health Education Practice: The BMSLSS is a useful indicator of LS for research and health education assessment purposes among African American adolescents where brevity of psychometric measures is imperative.

Association between Health Literacy and Subgroups of Health Risk Behaviors among Chinese Adolescents in Six Cities: A Study Using Regression Mixture Modeling.

Adolescents engage in health risk behaviors (HRBs) that influence their current and future health status. Health literacy (HL) is defined as how well a person can get and understand the health information and services, and use them to make good health decisions. HL can be used to participate in everyday activities actively and apply new information to the changing circumstances. HRBs commonly co-occur in adolescence, and few researchers have examined how HL predicts multiple HRBs in adolescence. In this study we examined the subgroups of HRBs, and investigated heterogeneity in the effects of HL on the subgroups. In total, 22,628 middle school students (10,990 males and 11,638 females) in six cities were enrolled by multistage stratified cluster sampling from November 2015 to January 2016. The measurement of HL was based on the Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ). Analyses were conducted with regression mixture modeling approach (RMM) by Mplus. By this study we found four latent classes among Chinese adolescents: Low-risk class, moderate-risk class 1 (smoking/alcohol use (AU)/screen time (ST)), moderate-risk class 2 (non-suicidal self-injury (NSSI)/suicidal behaviors (SB)/unintentional injury (UI)), and high-risk class (smoking/AU/ST/NSSI/SB/UI) which were 64.0%, 4.5%, 28.8% and 2.7% of involved students, respectively. Negative correlations were found between HL and HRBs: higher HL accompanied decreased HBRs. Compared to the low-risk class, moderate-risk class 1 (smoking/AU/ST), moderate-risk class 2 (NSSI/SB/UI), and high-risk class (smoking/AU/ST/NSSI/SB/UI) showed OR (95%CI) values of 0.990 (0.982–0.998), 0.981 (0.979–0.983) and 0.965 (0.959–0.970), respectively. Moreover, there was heterogeneity in the profiles of HRBs and HL in different classes. It is important for practitioners to examine HRBs in multiple domains concurrently rather than individually in isolation. Interventions and research should not only target adolescents engaging in high levels of risky behavior but also adolescents who are engaging in lower levels of risky behavior.

Poverty and Puberty: A Neurocognitive Study of Inhibitory Control in the Transition to Adolescence

Pubertal development during early adolescence is modestly associated with individual differences in slowly developing inhibitory control of impulses—an aspect of self-regulation associated with reward-seeking behaviors such as the onset and frequency of sexual activity. However, this effect may be much stronger in resource-poor environments. On the basis of life-history and r/K-selection theories, we tested the hypothesis that early pubertal timing would be more strongly associated with less mature neurocognitive inhibitory control in lower-income environments. In an economically diverse Appalachian sample (N = 157; 138 with complete neuroimaging data) of 14-year-olds (52% male), inhibitory control was measured using the multisource-interference task during functional MRI. Results showed that among poor youths only, more advanced puberty for one’s age was linked with lower inhibitory control for the neural but not the behavioral measure. This finding has implications regarding poverty, neurocognitive development, and health-risk behaviors in adolescence.

Clustering of lifestyle risk behaviours and its determinants among school-going adolescents in a middle-income country: a cross-sectional study

BackgroundLifestyle risk behaviours such as smoking, alcohol consumption, physical inactivity, sedentary behaviour and low fruit/vegetable intake have been identified as the major causes of chronic diseases. Such behaviours are usually instigated in adolescence and tend to persist into adulthood. Studies on the clustering of lifestyle risk behaviours among adolescents are scarce, particularly in developing countries. Therefore, the present paper aimed to determine the clustering of lifestyle risk behaviours and its determinants among school-going adolescents in Malaysia.MethodsData were extracted from a cross-sectional study, the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study, which was conducted from May to September 2013 across 11 states in Peninsular Malaysia. A two-stage proportionate-to-size sampling method was employed to select a total of 3578 school-going adolescents aged 16–17 years from 20 selected schools in urban and rural settlements, respectively. The MyAHRB study adopted a set of self-administered questionnaires adapted from the Global School-based Student’s Health Survey (GSHS) and the Youth Risk Behaviour Surveillance.ResultsThe results from the analysis of 2991 school-going adolescents aged 16–17 years showed that 16 (in boys) and 15 (in girls) out of 32 combinations of lifestyle risk behaviours clustered. Girls (aOR 2.82, 95% CI: 2.32–3.43) were significantly more likely to have clustered risk behaviours than boys; however, no significant associated factors were observed among girls. In contrast, boys of Malay descent (aOR 0.64, 95% CI: 0.46–0.89) or boys who had at least three friends (aOR 0.65, 95% CI: 0.43–0.99) were less likely to engage in multiple risk behaviours.ConclusionThe present study demonstrated the clustering of multiple risk behaviours that occurred in both genders; these results suggest that multiple behaviour intervention programmes, instead of programmes based on siloed approaches, should be advocated and targeted to the high-risk sub-populations identified in the present study.

Associations between physical activity, sedentary behavior, and health risk behaviors among adolescents from a city in Southern Brazil

This study examined the independent and combined associations of physical activity (PA) and sedentary behavior (SB) with health risk behaviors in Brazilian adolescents. Participants were 893 adolescents (454 girls) from Curitiba, Brazil. The Youth Activity Profile questionnaire evaluated PA and the Adolescent Sedentary Questionnaire evaluated SB. The Youth Risk Behavior Surveillance System (YRBS) questionnaire evaluated fruit, vegetable, alcohol, and tobacco consumption. Binary Logistic regression measured the independent and combined associations of PA and SB with risk behaviors. PA was inversely associated with low fruit (OR = 0.30; 95%CI: 0.18-0.51) and vegetable consumption (OR = 0.43; 95%CI: 0.25-0.73), and tobacco use (OR = 0.52; 95%CI: 0.29-0.89). However, PA was positively associated with mild (OR = 1.54; 95%CI: 1.08-2.19) and excessive alcohol use (OR = 1.53; 95%CI: 1.01-2.33). Higher levels of PA were associated with reduced risks of smoking and healthier eating patterns, but higher likelihood of alcohol consumption.

Self-Perceptions and Factors Associated With Being Put Down at School Among Middle and High School Students.

This study assessed the prevalence of verbally being put down by others and intrapersonal and normative factors associated with being put down by others among middle and high school students. Students (N = 1,027) completed the Adolescent Health Risk Behavior Survey. Over 16% of participants reported being put down at school. Students who identified with the negative words confused, unattractive, dull, and careless and identified less with the positive words popular, smart, considerate, cool, and self-confident reported being put down by others. High school students were less likely to be put down. As students scored higher on the Negative Self-Description Scale, their odds of being put down increased. As students scored higher on the Positive Self-Description Scale, their odds of being put down decreased. Students who perceived their friends drinking alcohol regularly were less likely to be put down. Strategies to enhance self-perceptions to raise self-awareness and form healthy/positive identities are needed.

Adolescent Health Risk Behaviors: Convergent, Discriminant and Predictive Validity of Self-Report and Cognitive Measures.

Self-report and cognitive tasks of reward sensitivity and self-regulation have influenced several developmental models that may explain the heightened engagement in risk behaviors during adolescence. Despite some inconsistencies across studies, few studies have explored the convergent, discriminant, and predictive validity of self-report and cognitive measures of these psychological characteristics in adolescence. The present study evaluated the convergent and discriminant validity of self-report and cognitive measures of reward sensitivity and self-regulation among 2017 adolescents (age M = 16.8, SD = 1.1; 56% female; 55% White, 22% Black, 8% Hispanic, 15% other race/ethnic; 49% 10th grade and 51% 12th grade). This study compared the predictive validity of an omnibus measure and specific measures of risk engagement. Convergent and discriminant validity from self-report to cognitive tasks were as predicted, although with weak convergent relationships. As hypothesized, compared to cognitive tasks, self-report measures consistently predicted risky behaviors and explained more variance in the models. These results demonstrate that while cognitive tasks can significantly predict certain risk behaviors, they require increased power to find the very small effects, raising questions about their use as implicit proxies for real world risk behavior.

Risk behaviours and alcohol in adolescence are negatively associated with testicular volume: results from the Amico-Andrologo survey.

Risk factors established during adolescence affect health outcomes in adulthood, although little is known about how adolescent health risk behaviours (HRBs) affect testicular development and reproductive health. To assess prevalence of HRBs among last year high school students; to describe the most prevalent andrological disorders in this cohort; to explore HRBs associated with andrological disorders and investigate factors possibly associated with impaired testicular development in puberty. The Amico-Andrologo Survey is a permanent nationwide surveillance programme conducted by the Italian Society of Andrology and Sexual Medicine and supported by the Ministry of Health. A nationally representative survey of final-year male high school students was conducted using a validated structured interview (n=10124) and medical examination (n=3816). Smoking (32.6%), drinking (80.6%) and use of illegal drugs (46.5%) are common in adolescence. 16.6% of subjects were overweight, 3.1% were underweight and 2.3% were obese. Among sexually active students (60.3%), unprotected sex was very common (48.3%). Only 11.6% had been treated for andrological disorders, despite an abnormal clinical examination in 34.6%. Bilateral testicular hypotrophy (14.0%), varicocoele (27.1%) and phimosis (7.1%) were the most prevalent disorders; 5.1% complained of premature ejaculation and 4.7% had an STI. Underweight and heavy alcohol or drug use were associated with testicular hypotrophy. HRBs emerged as significant predictors of testicular hypotrophy, explaining up to 9.6% of its variance. Limitations include risk of selection bias for voluntary physical examination and recall bias for the self-compiled questionnaire. There is an emerging global adverse trend of HRBs in male high school students. A significant proportion of adolescent males with unsuspected andrological disorders engage in behaviours that could impair testicular development. Greater attention to the prevention of andrological health in adolescence is needed.

Externalizing Behaviors Exacerbate the Link between Discrimination and Adolescent Health Risk Behaviors.

Discrimination based on race/ethnicity, sexual minority status, and gender is associated with higher rates of drinking, drug use and risky sexual behavior during adolescence. The current study explored variation in the link between these three types of discrimination and health risk behaviors by focusing on how this association differed according to externalizing problem behavior status. Participants in the Study of Early Child Care and Youth Development were asked about discrimination and their drinking, drug use and risky sexual behavior (age 15; 50% female, 82% White, n = 939). The association between discrimination and health risk behaviors varied according to both externalizing problem status and the type of discrimination, suggesting that individual-level characteristics (i.e., externalizing behaviors) shape variation in the consequences of discrimination for adolescent health outcomes. Ultimately, these findings point to the need for future research to better understand which adolescents are the most vulnerable to the consequences of discrimination, and when these vulnerabilities are most likely to occur.

Trends in Health-Risk Behaviors among Chinese Adolescents.

Adolescent health-risk behaviors can have long lasting negative effects throughout an individual’s life, and cause a major economic and social burden to society. This study aimed to estimate the prevalence of the health-risk behaviors among Chinese adolescents and to test the trends in health-risk behaviors without and with adjusting for sociodemographic characteristics. Data were drawn from the School-based Chinese Adolescents Health Survey, which is an ongoing school-based study about the health-risk behaviors among Chinese adolescents (7th to 12th grade). During the first wave through the third wave, the prevalence of lifetime, past 12-month, and past 30-day use of opioid decreased by 4.19%, 0.63%, and 0.56%, respectively. Moreover, the prevalence of lifetime, past 12-month, and past 30-day sedative use decreased by 3.03%, 0.65%, and 0.35%, respectively. During the three waves, most trends in the prevalence of health-risk behaviors were downward, with a few exceptions: The prevalence of lifetime smoking, drinking, methamphetamine use, and sleep disturbance increased by 7.15%, 13.08%, 0.48%, and 9.06%, respectively. The prevalence of lifetime 3,4-methylene dioxy methamphetamine use (from 0.49% to 0.48%), lifetime mephedrone use (from 0.30% to 0.24%), or suicide attempts (from 2.41% to 2.46%) remained stable.

Parenting perspective on the psychosocial correlates of adolescent sexual and reproductive health behavior among high school adolescents in Ethiopia

BackgroundWhile parents are a crucial part of the social environment in which adolescents live, learn and earn, they could play important roles in efforts to prevent adolescent sexual and reproductive health (SRH) risk behaviors and promote healthy development. Involving parents in prevention programs to risky SRH practices in adolescents requires understanding of the effect of different parenting practices and styles on these behaviors. The purpose of this study was to investigate the relationships between various aspects of perceived parenting and self-reported engagement in sexual risk behavior among adolescents.MethodsA cross-sectional study was employed among 406 randomly selected 14–19 years old high school adolescents in Legehida district, Northeast Ethiopia from 15 February to 15 March/ 2016. Structured and pre-tested self-administered questionnaire adapted from the Youth Risk Behavior Surveillance questionnaire was used for the data collection. Bivariate and multivariate logistic regression analysis with odds ratio along with the confidence interval of 95% were used. P-value < 0.05 were considered for statistical significance.ResultsAbout two-third (64.5%) of the participants reported that they had ever had sex. Nearly half (48.6%) of the participants who were currently sexually active reported that they engaged in at least one type of risky sexual behavior. Specifically, 42.7% reported starting sexual life earlier, 32.2% having more sexual partners in the past 12 months and 23.8% never used condom during the most recent sexual intercourse. High quality parent─adolescent relationships (AOR = 0.53; 95% CI (0.45–0.63) and authoritative form of parenting (AOR = 0.74; 95% CI (0.61–0.92) were associated with lower odds of engaging in risky sexual behaviors in adolescents. The odds of risky sexual behaviors were about three-fold higher in adolescents who perceived parental knowledge as poor (AOR = 2.97; 95% CI (1.51–4.25) and to some extent (AOR = 3.00; 95% CI (1.43–5.55) toward SRH than those whose parents were very knowledgeable. Adolescents with poor behavioral beliefs on SRH issues had a 37% increased odds of engaging in risky sexual behaviors.ConclusionsTherefore, to engage the parents within preventive interventions design to support healthy SRH behaviors among adolescents, the role of authoritative parenting style, and improved quality of parent-adolescent relationship, as well as improving adolescents’ behavioral beliefs and parental knowledge towards SRH are essential.

Effect of Electronic Screening With Personalized Feedback on Adolescent Health Risk Behaviors in a Primary Care Setting

Health risk behaviors are a leading cause of morbidity during adolescence. Screening and counseling for health risk behaviors are recommended but infrequently performed. To test the effect of an electronic screening and feedback tool on clinician counseling and adolescent-reported health risk behaviors. A randomized clinical trial compared electronic screening and feedback on an intention-to-treat basis with usual care among 300 youths 13 to 18 years of age at 5 pediatric clinics in the Pacific Northwest. Outcomes were assessed via electronic survey at 1 day and 3 months after the initial visit. Study data collection occurred from March 13, 2015, to November 29, 2016, and statistical analysis was conducted between February 6, 2017, and June 20, 2018. Youths in the intervention group (n = 147) received electronic screening and personalized feedback with clinician clinical decision support. Youths in the control group (n = 153) received standard screening and counseling as provided by their clinic. Youths' report of receipt of counseling during the visit and risk behaviors at 3 months. In the final study sample of 300 youths (intervention group, 75 girls and 72 boys; mean [SD] age, 14.5 [1.4 years]; and control group, 80 girls and 73 boys; mean [SD] age, 14.5 [1.4] years), 234 (78.0%) were aged 13 to 15 years. After adjusting for age, sex, and random effect of clinic, youths in the intervention group were more likely to receive counseling for each of their reported risk behaviors than were youths in the control group (adjusted rate ratio, 1.32; 95% CI, 1.07-1.63). Youths in the intervention group had a significantly greater reduction (β = -0.48; 95% CI, -0.89 to -0.02; P = .02) in their risk behavior scores at 3 months when compared with youths in the control group. Electronic screening of health risk behavior with clinical decision support and motivational feedback to teens can improve care delivery and outcomes. ClinicalTrials.gov identifier: NCT02360410.

Effectiveness of School-Based Education Programs on Health Risk Behaviors in Adolescents: South-East of Iran

Background: Improving and providing community health is one of the main pillars of community development. Objectives: The present study aimed at investigating the effect of school-based interventions on health-risk behaviors among adolescents in the South-East of Iran. Methods: This interventional quasi-experimental study recruited a total of 420 adolescent females in the 10th grade of public schools, selected by the census in Zahedan, Iran. The study tool was a questionnaire of high-risk health behaviors with a Content Validity Ratio (CVR) of 0.80, a Content Validity Index (CVI) of 0.88, and reliability (α) of 0.70. After the pre-test, multidimensional interventions (individual education, group education, individual counseling, modern education, and parents’ educational packages) were provided for the intervention group from October 2015 to June 2016. After a three-month interval, the post-test was conducted during October 2016. Results: The mean score changes in interventional and control group were -0.7 (2.3) and 0.1 (2.7) for high-risk behaviors; 0.8 (5.5) and -0.4 (5.2) for healthy nutritional behaviors, and physical activity behaviors with 1.4 (4.5) and 0.3 (5.1). Also, there was a positive significant relationship between score changes of high-risk behaviors (P < 0.001), healthy nutritional behaviors, and physical activity (P < 0.05) of students with study group (interventional and control) in univariate linear regression, yet in the multivariate linear model, only high-risk behaviors remained (P < 0.001). Furthermore, after the intervention, three simultaneous behaviors decreased among the students in the intervention group by 8.4% compared to 1.6% in the control group. The individual consultations among adolescents, who smoked cigarettes or hookahs, drank alcohol, abused drugs or had unprotected sex resulted in high-risk behaviors. Conclusions: To sum up, school-based interventions can improve health behaviors if they target multiple environmental and behavioral dimensions with a complementary strategy in the target society. Therefore, it is recommended for interventions to be designed and tailored to the needs of students and employed continuously to maintain the effect of education.

Qualitative Assessment of Emotion Regulation Strategies for Prevention of Health Risk Behaviors in Early Adolescents.

The ability to regulate emotions has been linked to a variety of adolescent health risk behaviors, including sexual risk behaviors, especially for adolescents who are experiencing mental health symptoms. However, there is limited information available on intuitive emotion regulation strategies for early adolescents with mental health symptoms to facilitate the adaptation of emotion regulation interventions for psychopathology to health risk behavior prevention. For example, interventions to prevent sexual risk behaviors in early adolescence have yet to specifically target emotion regulation. This paper describes the use of focus groups to identify emotion regulation strategies that were understood by and acceptable to early adolescents with mental health symptoms who are also more likely to engage in risky health behaviors. Qualitative data were collected through focus groups (k=5 groups) with 15 early adolescents with mental health symptoms. The most commonly generated emotion regulation strategies were leaving the situation, distraction, physical release, expressing oneself to someone, positive thinking, and considering other options. Translation of these findings for use in preventive health-risk behavior interventions (including for sexual risk) is discussed.

77. Check Yourself: A Randomized Trial of Electronic Screening And Personalized Feedback For Adolescent Health Risk Behaviors In Primary Care

Health risk behaviors increase during adolescence and are associated with significant morbidity. Screening and counseling are recommended as part of routine care but are infrequently performed. The goal of this study was to test the efficacy of an electronic multiple risk behavior screening and personalized motivational feedback tool, “Check Yourself”, on the delivery of provider counseling during well visits and subsequent teen behaviors. We conducted a randomized controlled trial comparing electronic screening and personalized feedback with usual care at five pediatric clinics. Three hundred 13-18 years old participants who were scheduled for a well visit between February, 2015 and August, 2017 were recruited. Age and sex stratified randomization was conducted prior to baseline assessment. Of the original sample, 293 (98%) and 292 (97%) completed follow-up surveys at 1 day and 3 months, respectively. Intervention youth received the Check Yourself tool including screening questions and personalized feedback based on a HEADSS framework. The providers received a summary report of risk behaviors rated as high, moderate or low risk based on pre-determined criteria. Control youth received usual care. Two main outcomes, determined a priori, included receipt of counseling during the well-visit and change in a summary score of all risk behaviors from baseline to 3 months. Among participating youth, 52% were female and the mean age was 14.5 (SD 1.42) years. 95% of the study sample had at least one moderate or high health risk behavior at baseline. The mean number of moderate-risk behaviors at baseline was 2.18 (SD 1.27, IQR 1-3) and high-risk behaviors was 0.68 (SD 0.95, IQR: 0-1). There were no significant differences in demographics or baseline rates of risk behaviors between control and intervention youth. After adjusting for age, sex, and random effect of clinic, intervention youth were 1.32 times more likely to receive counseling for each of their endorsed moderate and high risk behaviors than control youth (RR=1.32, 95% CI: 1.07,1.63). Intervention youth had a significantly greater reduction (β=-0.48, p=0.02) in their risk behavior scores at 3 months when compared to control youth, with sub-analyses showing that the intervention had a greater effect on high risk behaviors than on moderate risk behaviors. The Check Yourself tool increased provider counseling for health risk behaviors and was associated with a reduction in youth reported risk behaviors at 3 months. Given the importance of screening for health risk behaviors and the current lack of a consistent practice in primary care, integrated electronic screening and personalized feedback approaches could be an effective method for increasing detection of and intervention to reduce risk behaviors during adolescence.

Association between insufficient level of physical activity and multiple health risk behaviors in adolescents

Association between insufficient level of physical activity and multiple health risk behaviors in adolescents

Dietary habits and Health Risk Behaviors of the Adolescents who Experienced Part-Time Job: Based on the 13th (2017) Korea Youth Risk Behavior Online Survey

Dietary habits and Health Risk Behaviors of the Adolescents who Experienced Part-Time Job: Based on the 13th (2017) Korea Youth Risk Behavior Online Survey

Cultural Stress, Emotional well-being, and Health Risk Behaviors among Recent Immigrant Latinx families: The Moderating Role of Perceived Neighborhood Characteristics

Latinx families can experience cultural stressors, which can negatively influence their emotional and behavioral health. Few studies have examined if perceived neighborhood characteristics buffer against or exacerbate the negative effects of cultural stress on adolescent and parent health outcomes. To address this gap in the literature, this study investigated how parent (social cohesion, informal social control, extent of problems) and adolescent (support) perceived neighborhood factors moderated the associations of parent and adolescent cultural stress with parent and adolescent emotional and behavioral well-being. Data came from waves 1 and 3 of a six-wave longitudinal survey with 302 recent immigrant Latinx adolescents (47% female, Mage = 14.51 years) and their parents (74% mothers, Mage = 41.09 years). Results indicated that when parents reported low levels of neighborhood problems, adolescent cultural stress did not predict adolescent health risk behaviors. However, adolescent and parent cultural stress predicted higher levels of adolescents' sense of hope when parents perceived low levels of neighborhood problems. Furthermore, adolescent and parent cultural stress predicted higher youth depressive symptoms and health risk behaviors when positive neighborhood factors (informal social control, social cohesion) were high. Similarly, adolescent and parent cultural stress predicted lower adolescents' sense of hope and self-esteem when positive neighborhood factors were high. These findings indicate that efforts to reduce the negative effects of cultural stress on youth emotional and behavioral health may benefit from combating neighborhood problems. Results further indicate that research is needed to clarify unexpected findings. Directions for future research are discussed.

Exposure to second-hand smoke among secondary school-going adolescents: Findings from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study

Background: Exposure to second-hand smoke (SHS) is one of the main causes of morbidity and it has been proven to be associated with an increased likelihood of smoking initiation among adolescents. Nonetheless, evidence on SHS exposure among Malaysian adolescents is scarce. Therefore, this article aims to demonstrate the magnitude and factors associated with SHS exposure among school-going adolescents in selected secondary schools in Peninsular Malaysia. Methods: Data were derived from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study conducted in 2013. A total of 2599 adolescent were recruited into the study using a two-stage proportionate-to-size sampling method. Data were obtained from self-administered questionnaires. Descriptive analysis and multivariable logistic regression were performed to determine the risk factors/predictors associated with SHS. Results: More than half of the respondents had been exposed to SHS during the last one week (56.4%), and SHS exposure was significantly higher among respondents who smoked (94.0% vs. 49.9%, p &lt;0.001). Multivariable analysis revealed that the likelihood of exposure to SHS was higher among those who smoked (adjusted odds ratio (aOR) 12.90, 95% confidence interval (CI): 8.01–20.4), had at least one parent/guardian who smoked (aOR 5.49, 95% CI: 4.41–6.94) and adolescents of Malay descent (aOR 2.10, 95% CI: 1.68–2.63). Conclusion: Our findings suggested that the effectiveness of anti-smoking measures implemented in recent years to protect adolescents from the health risks of passive smoking were less evident. Therefore, educational and awareness programmes that emphasize the negative health impacts of SHS exposure on Malaysian adolescents, particularly when among smoking adults, should be intensified to help in preventing adoption of smoking behaviours among adolescents.

Depressive symptom trajectories and physical health: Persistence of problems from adolescence to young adulthood

BackgroundWe examine how depressive symptom trajectories are related to adolescent and young adult subjective health, health-promoting, health-risk, and sexual risk behaviors, as well as cardiometabolic risks. MethodData came from a community-based sample of youth (N = 662; 52% female) followed biannually, six times across 10 years. Latent class growth analysis identified four depressive symptom trajectories which were compared on adolescent (T1; ages 12–18) and young adult (T6; ages 22–29) health indicators. ResultsThe Low stable trajectory (49%) showed the fewest health risks. The Persistent high trajectory (9%) reported higher physical symptoms, lower physical self-concept, less physical activity and sleep, and higher rates of smoking and sexual risk behaviors than the Low stable trajectory and risks for physical symptoms, physical self-concept, and physical activity worsened in young adulthood. Increasers (21%) showed risks for physical symptoms, physical activity, and sleep in adolescence and problems for physical symptoms and physical self-concept persisted in young adulthood. Decreasers (22%) showed risks for physical symptoms, physical self-concept, physical activity, and sleep in adolescence but these risks resolved into young adulthood. LimitationsFindings may not generalize to ethnic minorities. Sex differences were not examined due to sample size limitations and most variables, except cardiometabolic risks, were self-reported. ConclusionsFindings suggest early treatment of depressive symptoms that includes strategies addressing physical symptoms, physical self-concept, and physical activity may prove beneficial. Screening youth for physical symptoms and declines in health-promoting behaviors may also identify youth at risk of depression onset and progression.